Redefining the pharmacist of the future

The pharmacy profession is evolving rapidly, with a strong push toward clinical prescribing roles. However, there is growing tension between this exciting clinical direction, the diverse interests of our emerging foundation pharmacists — who are central to this future — and the challenge of ensuring that our workforce also develops the wider competencies and awareness needed to be effective in today’s highly complex integrated care systems.

The unparalleled clinical infrastructure and opportunity offered by community pharmacy, the rollout of Pharmacy First, and the introduction of independent prescriber pathfinders — alongside the growth of pharmacy in general practice — all allow the profession to use its accessibility and public trust to deliver clinical care closer to home in a way we’ve never seen before. The addition of post-registration, non-medical prescribing, alongside the development of advanced and consultant-level credentialing pathways, only adds to this promising picture of the future.

With that in mind, we must also ensure this clinical career pathway is seen and nurtured as just one of the many potential options for the next generation of pharmacists. 

Helping retain future talent

Persistently high attrition rates among first- and second-year pharmacy undergraduates — as raised in The Pharmaceutical Journal in October 2024 by investigations editor Sophie Willis — suggest pharmacy is losing talented individuals to other industries. Although primarily attributed to the COVID-19 pandemic, this should serve as a warning that the needs and expectations of our future workforce have changed, and nothing will return to ‘how it was before’. 

Many undergraduates with undoubted talent may thrive in pharmacy if alternative training or employment models were available. We should consider whether a more varied educational experience could help the profession to develop richer, more rounded services and greater social benefit. 

Elective undergraduate pathways could introduce early exposure to fields that already have growing influence on both health-seeking behaviour and service provision, such as AI, health content creation, healthcare consultancy, service development and redesign, and strategic communication. 

Unless we act soon, we risk early disenfranchisement and loss of early-career pharmacists who do not identify with a purely clinical future. The wider consequence is a profession that lacks diversity of thought, skills and creativity that are the foundations of a high performing ‘team pharmacy’. Whether at provider, institutional or whole professional level, we are the profession that can truly lead medicines optimisation in ways that fully engage and empower patients. 

By offering more varied career pathways early on, we can build talent pipelines that appeal to undergraduates who are unsure about a clinical future. These broader options could help pharmacy better serve the increasingly complex needs of the wider health and care system. 

One practical suggestion may be to incorporate 6-month or 12-month placements into the 4-year MPharm degree but in an alternative sector or discipline to better help our future workforce develop their goals and direction. This could include voluntary or third-sector organisations, operational management roles (in a similar manner to the NHS Graduate Management Training Scheme), public health teams or similar, and complementing our skillset to challenge the way we think and enter the workforce with a unique view to create change. 

From a whole-system perspective, this kind of approach — if done collaboratively — could also build a sense of belonging among students, potentially encouraging them to stay and work in the region after graduation, which is a challenge that employers across England are grappling with. For undergraduates, the benefits of their learning — the ‘so what?’ — is crystallised in a way that traditional pharmacy environments alone may not be able to do.

In effect, this approach would use the capacity of the whole system — both health and care — to support the holistic development of future pharmacists. This is the only truly sustainable way to expand both undergraduate placements and post-registration training capacity, without overwhelming existing providers. If developed in the spirit of collaboration, this approach could start to create a self-sustaining talent pipeline while creating a sustainable workforce pool and embedding future pharmacists earlier in spaces where we have historically been underrepresented.

Building a system-aware, flexible, resilient workforce

In Bath, Swindon and Wiltshire (BSW), we have moved toward this vision of the future with the mobilisation in July 2025 of a single employer model for trainee pharmacists. Initially designed to ensure each trainee gets a high-quality year regardless of sector, this model has also allowed us to explore integration of wider system awareness into the trainee year without the usual contractual barriers. One example is a 60:40 split between an acute trust and a health inequalities team. In future, why could this split not include voluntary sector organisations, public health and anywhere clinical influence could improve population health in its broadest sense?

Opportunities potentially exist even earlier in the undergraduate journey: through a partnership with the University of Bath’s Gold Scholarship programme, one undergraduate led a project to align the system’s approach to inclusive recruitment and practice. Another student was supported to manage trainee communications across the system for 12 months. Both developed transferable skills, gained early leadership experience, and — crucially — a sense of belonging through work that had real meaning and long-term impact.

For both examples, the model involves pooling existing resource — whether funds or staff — at system level, supplemented from partner hosts. More importantly, determinants of success are a clear vision of the future and a shift from the ‘scarcity mindset’ to one of collaboration and long-term benefit.

This approach to development will no doubt raise questions about pharmacy’s identity and what it means to be a pharmacist, in ways wiser heads than mine could articulate. We might hear concerns of ‘diluting’ the profession. However, it could also give us the scale and diversity of future leadership we need, particularly in non-clinical or ‘infrastructural’ roles that still demand deep professional insight.

There is strong alignment between this idea and the Royal Pharmaceutical Society’s (RPS) proposals for a Royal College of Pharmacy, and its focus on future workforce transformation.

Quality management pioneer W. Edward Deming said that “a badly designed system will beat a talented individual every single time”, so how do we identify, inspire and support the ‘system architects’ of the future, from within our own profession?

Pharmacists often enter the workforce equipped to function within a theoretically well-oiled system. However, unless they are given the tools and experience to navigate complexity, they may struggle to improve, influence or redesign the messier systems they find themselves in. It is here, in this mismatch between theory and reality, that helplessness from a perceived lack of agency or ability to influence change can take root, and eventually lead to burnout. This is a well-recognised issue across the profession as outlined in stark terms by the 2024 RPS ‘Workforce and wellbeing survey’, which estimated that 86% of pharmacists are at high risk of burnout. 

Sustained remedial action is needed, starting now.

The pharmacist of the future remains a medicines expert, but to maximise influence as a whole profession, they must also be equipped — deliberately and systemically — to use their knowledge confidently in diverse new spaces: alongside third-sector organisations, in social care, public health, operational improvement, social media and beyond. 

Perhaps if we aimed to retain closer 100% of pharmacy undergraduates, comfortable with the fact that some would be more effective as ‘system architects’ than as ‘fully clinical’ non-medical prescribers, we could deliver more value to society.